NPIMap

Organization Active NPI

Daybreak Treatment Care, LLC

  • Clinic/Center
  • West Berlin, NJ
National Provider Identifier
1699809384
Registry record updated Feb 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
10020-03-05 Issued in NJ
Legal business name
DAYBREAK TREATMENT CARE, LLC
Practice address
258-68 Pinedge Dr.
West Berlin, NJ 08091
Phone
(856) 753-8111
Fax
(856) 753-3339
NPI assigned
Mar 15, 2007
Organization subpart
Yes
Parent organization
DAYBREAK TREATMENT CARE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 14, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Jeffrey I. Goldstein, JD, MBA
Title
Ceo
Phone
(732) 245-8473

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 10020-03-05 NJ Primary
Adult Mental Health Clinic/Center 261QM0850X 10020-02-05 NJ

Addresses

Primary practice location

258-68 Pinedge Dr.
West Berlin, NJ 08091

Mailing address

P.O. Box 2136
Ocean, NJ 07712
Phone (732) 922-0591

Other identifiers 1

IdentifierTypeStateIssuer
0034771MedicaidNJ

Other names 1

  • Daybreak Treatment Care Program II Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Daybreak Treatment Care LLC3 organizations share this tax ID, including this one
Part of
Daybreak Treatment Care

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297641600000",
    "number": "1699809384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 2136",
            "city": "OCEAN",
            "state": "NJ",
            "postal_code": "07712",
            "telephone_number": "732-922-0591",
            "fax_number": "732-922-0593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258-68 PINEDGE DR.",
            "city": "WEST BERLIN",
            "state": "NJ",
            "postal_code": "08091",
            "telephone_number": "856-753-8111",
            "fax_number": "856-753-3339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAYBREAK TREATMENT CARE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DAYBREAK TREATMENT CARE, LLC",
        "enumeration_date": "2007-03-15",
        "last_updated": "2011-02-14",
        "status": "A",
        "authorized_official_last_name": "GOLDSTEIN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "I.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "732-245-8473",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "JD, MBA"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NJ",
            "license": "10020-03-05",
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NJ",
            "license": "10020-02-05",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0034771",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Daybreak Treatment Care Program II",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Berlin, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.